Success rates and predictors of outcomes of type I tympanoplasty performed by residents in a teaching tertiary hospital.

Autor:	Mangia LRL; Department of Otolaryngology and Head and Neck Surgery, Complexo Hospital de Clínicas - Universidade Federal Do Paraná (CHC-UFPR), Curitiba, Brazil.; Complexo Hospital de Clínicas - Universidade Federal Do Paraná (CHC-UFPR), Curso de Medicina, Curitiba, Brazil., Amadeu NT; Department of Otolaryngology and Head and Neck Surgery, Complexo Hospital de Clínicas - Universidade Federal Do Paraná (CHC-UFPR), Curitiba, Brazil., da Silva Oliveira M; Complexo Hospital de Clínicas - Universidade Federal Do Paraná (CHC-UFPR), Curso de Medicina, Curitiba, Brazil., Patzer LS; Complexo Hospital de Clínicas - Universidade Federal Do Paraná (CHC-UFPR), Curso de Medicina, Curitiba, Brazil., Somensi ES; Complexo Hospital de Clínicas - Universidade Federal Do Paraná (CHC-UFPR), Curso de Medicina, Curitiba, Brazil., Hamerschmidt R; Department of Otolaryngology and Head and Neck Surgery, Complexo Hospital de Clínicas - Universidade Federal Do Paraná (CHC-UFPR), Curitiba, Brazil.; Complexo Hospital de Clínicas - Universidade Federal Do Paraná (CHC-UFPR), Curso de Medicina, Curitiba, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of otology [J Otol] 2023 Oct; Vol. 18 (4), pp. 214-219. Date of Electronic Publication: 2023 Sep 09.
DOI:	10.1016/j.joto.2023.09.003
Abstrakt:	Several technical variations of tympanoplasty have been reported, usually involving the type of graft and/or instruments used. Few studies have focused on the outcome of type-1 tympanoplasty specifically in teaching scenarios. We aimed to describe the results of type-1 tympanoplasty performed by residents, and to investigate potential predictive factors of surgical success. To do so, we did a retrospective analysis of medical records of patients who underwent type-1 tympanoplasty in a tertiary university hospital. We evaluated the tympanic membrane closure and audiometric outcomes during the first year of follow-up, and compared the results according to some clinical and surgical factors. 130 operated ears were included in the study. The closure rate reached 84.12% after one month and 72.72% after twelve months of surgery. The mean air-bone gap was 22.98 dB preoperatively, and reached 10.55 dB after surgery. Perforation closure rates were 85% and 57.14% for those operated by endoscopic and microscopic-assisted approaches, respectively (p = 0.004). The use of cartilage grafts and time without otorrhea of more than three months prior to surgery were also predictors of surgical success (p = 0.002 and 0.041, respectively). Gender, age, perforation size, contralateral disease, operated side, reoperation, and degree of hearing loss did not significantly interfere with outcomes. Tympanoplasty showed good overall results when performed by residents, although inferior to those reported by experienced surgeons. The use of the endoscope, cartilage grafting, and longer preoperative time without otorrhea were predictors of surgical success in this scenario. Level of Evidence: IIB. (© 2023 PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd.)
Databáze:	MEDLINE
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